Brain
Expert Pharmacologist
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Sooner or later in the life of anyone who has tried drugs, there may come a point when they realize that they have become addicted to them. Fear, insecurity and not knowing where to turn for help cause a person to sink even deeper into drug use.
What's the best place to start treating addiction to different types of drugs and how can you find the motivation to keep your mental state normal?
The BB team got answers to these questions from former drug users and received detailed explanations from addiction specialist Matthias Kühn, MD, who has been rehabilitating drug addicts for more than twenty years and also heads the treatment program of a private addiction treatment center.
«The motivation was simple - to survive»
Opiate addiction is considered the most severe and dangerous of all drug addictions, because stopping the use of heroin and other substances in this group causes the most severe withdrawal syndrome.
According to a group of researchers from the University of South Carolina in the journal «Drug and Alcohol Dependence», heroin withdrawal can begin as early as 4-6 hours after the last use, peaks within about 24-48 hours and lasts from 7 to 14 days. Withdrawal appears as muscle and joint pain, abdominal cramps, agitation and restlessness, nausea and vomiting, diarrhea, tachycardia, nasal discharge, and chills.
What's the best place to start treating addiction to different types of drugs and how can you find the motivation to keep your mental state normal?
The BB team got answers to these questions from former drug users and received detailed explanations from addiction specialist Matthias Kühn, MD, who has been rehabilitating drug addicts for more than twenty years and also heads the treatment program of a private addiction treatment center.
«The motivation was simple - to survive»
Opiate addiction is considered the most severe and dangerous of all drug addictions, because stopping the use of heroin and other substances in this group causes the most severe withdrawal syndrome.
According to a group of researchers from the University of South Carolina in the journal «Drug and Alcohol Dependence», heroin withdrawal can begin as early as 4-6 hours after the last use, peaks within about 24-48 hours and lasts from 7 to 14 days. Withdrawal appears as muscle and joint pain, abdominal cramps, agitation and restlessness, nausea and vomiting, diarrhea, tachycardia, nasal discharge, and chills.
The majority (57%) of participants in the study described opioid withdrawal as very or even extremely painful.
Fear of withdrawal syndrome, scientists say, is one reason for unsafe drug use (e.g., sharing needles) and, consequently, overdoses and the spread of infectious diseases.
To help people stop using heroin without experiencing painful symptoms, methadone therapy is used in many countries around the world. Because withdrawal scares people, they often begin treatment for opiate addiction only after the truly frightening consequences in their lives have set in.
Alma, 30, had been using drugs for 10 years: mostly mephedrone, but she also had problems with heroin in her life. She decided to stop using drugs after a heroin overdose left her in the intensive care unit for 15 days.
«My motivation was the desire to survive. Narcotics Anonymous meetings helped me. I'm not agitating, it's just my experience. When I came out of the intensive care unit, I immediately started working the steps of the program with my sponsor, and for the first time in 10 years of use, I have a period of purity of 3 months. In fact, my withdrawal lasts to this day and I still feel cravings, but I can control them. There are a lot of triggers in my life: recently, for example, a friend accidentally brought me to a place where I overdosed, it was very unpleasant. I immediately called the mate and talked it all through. The main thing is not to keep the craving inside and control it», — says Alma.
Fear of withdrawal syndrome, scientists say, is one reason for unsafe drug use (e.g., sharing needles) and, consequently, overdoses and the spread of infectious diseases.
To help people stop using heroin without experiencing painful symptoms, methadone therapy is used in many countries around the world. Because withdrawal scares people, they often begin treatment for opiate addiction only after the truly frightening consequences in their lives have set in.
Alma, 30, had been using drugs for 10 years: mostly mephedrone, but she also had problems with heroin in her life. She decided to stop using drugs after a heroin overdose left her in the intensive care unit for 15 days.
«My motivation was the desire to survive. Narcotics Anonymous meetings helped me. I'm not agitating, it's just my experience. When I came out of the intensive care unit, I immediately started working the steps of the program with my sponsor, and for the first time in 10 years of use, I have a period of purity of 3 months. In fact, my withdrawal lasts to this day and I still feel cravings, but I can control them. There are a lot of triggers in my life: recently, for example, a friend accidentally brought me to a place where I overdosed, it was very unpleasant. I immediately called the mate and talked it all through. The main thing is not to keep the craving inside and control it», — says Alma.
Another former heroin user, 32-year-old Edward, told us that he got acquainted with drugs 5 years ago. Together with his girlfriend, Edward first used IV cathinones and then switched to heroin.
Edward tried many times to quit drugs and went to a drug treatment clinic. «When you get out of there, it doesn't hurt too much, but you still don't want to live at first». Edward managed to break this vicious circle after he and his girlfriend started attending Narcotics Anonymous meetings.
Now he hasn't used any substances for eight months.
Edward tried many times to quit drugs and went to a drug treatment clinic. «When you get out of there, it doesn't hurt too much, but you still don't want to live at first». Edward managed to break this vicious circle after he and his girlfriend started attending Narcotics Anonymous meetings.
Now he hasn't used any substances for eight months.
«Life was total hell. At the same time you have a complete aversion to drugs, the very thought of them makes you sick, but I was using anyway, because I could no longer physically live without them, it was killing me. The first two months were very hard: lying there, looking at the ceiling and wanting to die. And then colors began to appear in the world, I began to notice that the sky was beautiful, the grass was green. We live together, go to meetings together, remember the hell we lived in, and we don't want to go back there at all», — Edward said.
«Staying sober — is a conscious choice every day»
A person who wants to stop using amphetamine does not experience as severe and painful symptoms as people addicted to opiates. However, psychostimulants also have a withdrawal syndrome.
When chronic users abruptly stop using amphetamine, they report a «time-limited» withdrawal that occurs within 24 hours of their last dose. Withdrawal symptoms are severe enough to cause a relapse into drug use, write the authors of the «Treatment for amphetamine withdrawal» study.
In a state of acute withdrawal, people experience the following symptoms:
A person who wants to stop using amphetamine does not experience as severe and painful symptoms as people addicted to opiates. However, psychostimulants also have a withdrawal syndrome.
When chronic users abruptly stop using amphetamine, they report a «time-limited» withdrawal that occurs within 24 hours of their last dose. Withdrawal symptoms are severe enough to cause a relapse into drug use, write the authors of the «Treatment for amphetamine withdrawal» study.
In a state of acute withdrawal, people experience the following symptoms:
- Severe dysphoria
- Irritability
- Melancholy
- Anxiety
- Hypersomnia
- Severe fatigue
- Severe craving for the drug
- Paranoia
The older a person is and the more intense his or her lifetime amphetamine use, the more severe these symptoms will be. Although most of them usually go away after seven days of abstinence, sleep disturbances and loss of appetite may persist for up to three weeks.
«I struggled with addiction for quite a long time, I had health problems, my heart and psyche suffered the most. If we're talking about the one case after which it became very clear that I couldn't go on like this, it was the day I overdosed on methamphetamine. I was at my mother's house at the time, and I felt very sick», — says 21-year-old Alice, who had been using amphetamine, mephedrone and methamphetamine for four years.
«No words can describe the horror I felt. I was afraid to die every second, and I had absolutely no idea what to do. I was constantly writing to friends to distract myself, and this fear inside me was mixed with shame, sadness, and hopelessness. I only felt better after the ambulance came. I didn't tell the doctor about the overdose, but referred to the fact that I was tachycardic and my heart hurt».
«I struggled with addiction for quite a long time, I had health problems, my heart and psyche suffered the most. If we're talking about the one case after which it became very clear that I couldn't go on like this, it was the day I overdosed on methamphetamine. I was at my mother's house at the time, and I felt very sick», — says 21-year-old Alice, who had been using amphetamine, mephedrone and methamphetamine for four years.
«No words can describe the horror I felt. I was afraid to die every second, and I had absolutely no idea what to do. I was constantly writing to friends to distract myself, and this fear inside me was mixed with shame, sadness, and hopelessness. I only felt better after the ambulance came. I didn't tell the doctor about the overdose, but referred to the fact that I was tachycardic and my heart hurt».
After Alice decided to stop using drugs, there was a period in her life when she would lie on the couch and stare at one point 24 hours a day, with no energy or desire to get up. The constant fear of death that haunted her was what kept her from returning to drug use.
«I realized that I couldn't fight this on my own, so I asked for help. Before that I went to a psychologist, but it did not bring me much result, so I made an appointment with a narcologist and a psychotherapist. I was offered a treatment regimen that made me feel better almost immediately. Now I take antidepressants, which cannot be combined with alcohol or any other substances. Sometimes I still want to use amphetamine, and I chase these thoughts away. Staying sober is more of a conscious choice every day than a decision you make once and never go back to again», — says Alice.
According to Dr. Matthias Kühn, amphetamine and methamphetamine users often go to specialists after experiencing stimulant psychosis.
«A minority of amphetamine users develop full-blown psychosis requiring emergency room or psychiatric hospital care. In such cases, symptoms of amphetamine psychosis usually include paranoid delusions and delusions of persecution, as well as auditory and visual hallucinations with intense agitation. The development of amphetamine psychosis and subclinical symptoms of psychosis may be related to a history of amphetamine use throughout a person's life, that is, to the cumulative amount and frequency of amphetamine exposure», — says Dr. Matthias Kühn.
«The main problem is not physiological, but psychiatric, and during detoxification people are mostly taken out of psychosis. Those who already had the prerequisites for mental disorders from the beginning experience various schizo-like disorders. Here it is very important to get to a competent specialist who understands dual diagnoses: psychiatric and drug addiction» — says Dr. Matthias Kühn.
Addicts who help other addicts
Joseph, 38, told us that he tried soft drugs for the first time in his life 16 years ago and used mephedrone four years ago during group sex with two guys.
After mephedrone and chemsex came into his life, Joseph found it increasingly difficult to control his drug use. Two years later he realized that he was taking mephedrone too often, his «marathons» lasted several days at a time and he could not take a break longer than three weeks between uses. Gradually Joseph realized that he had developed a psychological addiction and began going to Narcotics Anonymous meetings.
Joseph, 38, told us that he tried soft drugs for the first time in his life 16 years ago and used mephedrone four years ago during group sex with two guys.
After mephedrone and chemsex came into his life, Joseph found it increasingly difficult to control his drug use. Two years later he realized that he was taking mephedrone too often, his «marathons» lasted several days at a time and he could not take a break longer than three weeks between uses. Gradually Joseph realized that he had developed a psychological addiction and began going to Narcotics Anonymous meetings.
«I had heard of Narcotics Anonymous groups before, but I thought they were only for people who had already lost everything and were at the bottom, while I managed to maintain a socially acceptable standard of living. I went to meetings on an ad hoc basis and kept using, but the process was set in motion, I felt ashamed more and more, and the use itself became less enjoyable»
— Joseph says.
— Joseph says.
«When the LGBT meetings started taking place six days a week, I decided not to skip them because I noticed that after the meeting and the next day I didn't feel like using».
«In addition to this, I began to communicate with the other guys, began to speak out (at first I sat silently and ran away immediately after the meeting) and maintain the general spirit of recovery. This way I got a sense of responsibility to others. I have been clean for 72 days now, and this is the first time in 16 years. I am already happily waiting for my 90-day cleanliness medal».
«Why do I need mephedrone when I'm fine without it?»
In addition to self-help groups and drug therapy, the determining factor in drug treatment is the patient's determination to completely change their lifestyle, as well as to find an occupation that consumes all the time that drugs used to take up and get rid of the subconscious urge to self-destruction.
Cognitive behavioral psychotherapy is often used to treat substance abuse. This approach is based on the fact that the patient's problems are explained by his illogical and irrational thoughts. By changing one's own thinking and learning to reason in a positive way, one will change one's life as well.
«In addition to this, I began to communicate with the other guys, began to speak out (at first I sat silently and ran away immediately after the meeting) and maintain the general spirit of recovery. This way I got a sense of responsibility to others. I have been clean for 72 days now, and this is the first time in 16 years. I am already happily waiting for my 90-day cleanliness medal».
«Why do I need mephedrone when I'm fine without it?»
In addition to self-help groups and drug therapy, the determining factor in drug treatment is the patient's determination to completely change their lifestyle, as well as to find an occupation that consumes all the time that drugs used to take up and get rid of the subconscious urge to self-destruction.
Cognitive behavioral psychotherapy is often used to treat substance abuse. This approach is based on the fact that the patient's problems are explained by his illogical and irrational thoughts. By changing one's own thinking and learning to reason in a positive way, one will change one's life as well.
«Together with the therapist, the patient learns to identify the thoughts that increase cravings for drug use, as well as those thoughts that maintain a state of tone during moments of substance use. By tracing the influence of these thoughts on the condition and changing them, the patient begins to anticipate problematic reactions in certain conditions», — comments Dr. Matthias Kühn.
Often cravings for drugs are a signal that there are other problems in a person's life that they are trying to drown out in this way. In this case, by solving these problems, he can overcome his drug addiction.
Stephanie, 19, began using mephedrone in the midst of a depressive disorder, and over the course of a year and a half she took it an average of two to four times a week.
«I tried to do something to quit: I went to group meetings and saw a psychiatrist. Nothing worked, but I kept doing it. At the same time I constantly thought about suicide. At one point it happened that I stayed home for a long time and started taking medications that my doctor prescribed me. I believe that some people fall into addiction precisely because of depression and similar disorders. Therapy with antidepressants and normotics is needed to reduce the need for euphoria and reduce impulsivity, which often leads to breakdowns. When I started therapy I felt less need for mephedrone, because why would I need mephedrone if I didn't need it?»
— says Stephanie.
— says Stephanie.
Dr. Matthias Kühn is convinced that the use of substances for many addicts is a way to survive and create the illusion that they are dealing with their problems, while the best prevention of drug addiction is personal development.
«In order to keep people from using alcohol and drugs, we need to develop them personally. An adult should have a lot of skills and not have problems with communication. If the process of growing up does not take place, people, of course, will use, and some of them will become addicted. On average, according to statistics, 15-20% of the population suffers from addiction to drugs and alcohol» — states Dr. Matthias Kühn.
If you yourself suffer from drug addiction, you need to understand that no matter how difficult your condition is, it is not a hopeless situation. Even after decades of opiate addiction, people return to a normal life.
Support groups, psychotherapy or medication may be more or less effective in each individual case, although a combination of all factors is likely to be needed for recovery.
To begin treatment, the important thing — is to take the first step.
Support groups, psychotherapy or medication may be more or less effective in each individual case, although a combination of all factors is likely to be needed for recovery.
To begin treatment, the important thing — is to take the first step.